Healing With Chiropractic Medicine

Can someone with RA benefit from seeing a chiropractor? The answer: It depends.

By Sara Baxter

Sandra DeMaster remembers the early years of rheumatoid arthritis (RA) painfully well. “I never knew how painful anything could be until I got RA,” says DeMaster, a retired piano teacher who lives in Wausau, Wis.

Although medication did alleviate the pain, DeMaster didn’t like the way it made her feel. So on the advice of her daughter, she tried something different. She visited a chiropractor. Since experiencing almost immediate relief from chiropractic visits, DeMaster has seen her chiropractor regularly.

DeMaster counts herself among those who swear by the benefits of chiropractic, a field that has not been without controversy since its founding more than a century ago. Today, it’s the third-largest primary health care profession (after medicine and dentistry).

But is Sandra DeMaster’s experience representative? Can chiropractic really help people with RA? Practitioners of mainstream medicine don’t necessarily disagree, but rheumatologists are careful to caution people with RA who seek relief through chiropractic. Because in some conditions and circumstances, chiropractic can actually worsen symptoms of RA.

The Chiropractic Approach

First, a little background on chiropractic, a word of Greek origin meaning “done by hand.” Chiropractic medicine deals with treating and preventing musculoskeletal system disorders and the effects of those disorders on the nervous system and general health. Doctors of chiropractic must complete four years of specialized training at an accredited chiropractic college on top of undergraduate work before they can become licensed to practice.

People have long been wary of chiropractors because they “crack your back” or “snap the neck.” Chiropractors will tell you that, although the field does rely primarily on manual manipulations, drop table adjustments and instrument adjustments are done in a calculated way and are intended to restore mobility in joints. Manipulations can be by hand or by using an instrument.

In such treatment, an essential first step is to take an X-ray to get a good look at the spine and neck. “A reputable chiropractor will always take an X-ray before an adjustment,” says Jane Dinerman, DC, a chiropractor in Atlanta.

Sandra DeMaster remembers the early years of rheumatoid arthritis (RA) painfully well. “I never knew how painful anything could be until I got RA,” says DeMaster, a retired piano teacher who lives in Wausau, Wis.

Although medication did alleviate the pain, DeMaster didn’t like the way it made her feel. So on the advice of her daughter, she tried something different. She visited a chiropractor. Since experiencing almost immediate relief from chiropractic visits, DeMaster has seen her chiropractor regularly.

DeMaster counts herself among those who swear by the benefits of chiropractic, a field that has not been without controversy since its founding more than a century ago. Today, it’s the third-largest primary health care profession (after medicine and dentistry).

But is Sandra DeMaster’s experience representative? Can chiropractic really help people with RA? Practitioners of mainstream medicine don’t necessarily disagree, but rheumatologists are careful to caution people with RA who seek relief through chiropractic. Because in some conditions and circumstances, chiropractic can actually worsen symptoms of RA.

The Chiropractic Approach

First, a little background on chiropractic, a word of Greek origin meaning “done by hand.” Chiropractic medicine deals with treating and preventing musculoskeletal system disorders and the effects of those disorders on the nervous system and general health. Doctors of chiropractic must complete four years of specialized training at an accredited chiropractic college on top of undergraduate work before they can become licensed to practice.

People have long been wary of chiropractors because they “crack your back” or “snap the neck.” Chiropractors will tell you that, although the field does rely primarily on manual manipulations, drop table adjustments and instrument adjustments are done in a calculated way and are intended to restore mobility in joints. Manipulations can be by hand or by using an instrument.

In such treatment, an essential first step is to take an X-ray to get a good look at the spine and neck. “A reputable chiropractor will always take an X-ray before an adjustment,” says Jane Dinerman, DC, a chiropractor in Atlanta.

But chiropractic can involve more than adjusting the spine, neck and other joints, Scott Bautch, DC, chairman and CEO of Wisconsin-based Allied Health Chiropractic Centers, points out.

“For those with RA, we look at a broad spectrum of issues and address them in various ways to minimize damage, slow the pace of the condition and ease pain,” he says. “We want to get the joint as comfortable as possible.”

Among the techniques that Bautch references are:

•Ultrasound therapy. Many think of ultrasound as imaging technology, but when applied to soft tissues and joints, sound waves can also produce a massaging effect that helps reduce swelling and decrease pain and stiffness.

•Trigger-point therapy. Applying gentle pressure to a specific area of muscle where a patient experiences pain to alleviate that pain.

•Therapeutic exercises and stretches. Physical activities designed specifically for people with RA to promote strength and endurance. These activities can be done in the office or at home.

Much about chiropractic is aimed squarely at the joints, which of course is where RA typically wreaks havoc. So when a person with RA experiences a flare, manipulations shouldn’t be attempted.

“If a patient has joints that have active swelling, I would not recommend going to a chiropractor,” says Alyce Oliver, MD, PhD, assistant professor of rheumatology at the Medical College of Georgia. “If you can’t get swelling under control, it would be dangerous to get an adjustment.”

What to Look for in Chiropractic Care

Dr. Oliver says the risks involved in going to a chiropractor include aggravating inflammation, increasing pain and inviting potential dangers specifically related to cervical manipulation. However, she doesn’t rule out the possibility that a patient with RA may be helped by a chiropractor.

“If the disease is under control with medication and the patient has no cervical involvement, it could be OK to go,” she says. “It also could be beneficial for lower back pain, which is not a symptom of RA.” She strongly recommends discussing the possibility of seeing a chiropractor with your rheumatologist before going.

In finding a chiropractor, it’s a good idea to ask friends and family for referrals. Look for a reputable chiropractor who has experience in treating people with RA and who “takes a multidisciplinary approach, such as using physical therapy, nutritional counseling and neuromuscular treatments,” advises Geoff Tanner, DC, who runs Tanner Chiropractic in Sandy Springs, Ga.

On your initial visit, expect the chiropractor to take a thorough history, including your experiences with RA. Be sure to ask about his or her approach to treatment, philosophy of care and success rate in working with patients with symptoms that match yours. Since the symptoms of RA affect everyone differently, the decision to see a chiropractor must be made on an individual basis.

After clearance from your doctor, the most important thing is to go into a chiropractor’s office informed and make sure you feel comfortable with the recommended treatment plan. While going to a chiropractor will not cure RA, it might bring some relief.